WAUPACA COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES
Transportation Coordination Committee Minutes
July 12, 2012
This meeting and all other meetings of this committee are open to the public. Proper notice has been posted and given to the press in accordance with Wisconsin statutes so that the citizenry may be aware of the time, place and agenda of this meeting.
Meeting called to order by Chairman Gerald Murphy at the Waupaca County Courthouse, Waupaca, WI, Room – Lower Level 43, at 2:03 p.m.
MEMBERS PRESENT: Carl Kietzmann, Dave Lowe, Karl Schulte, Teri Moe, Jan Henschel (representing Gene Ruppert), Nancy Ferg, and Gerald Murphy
MEMBERS EXCUSED: Gene Ruppert, Robert Thompson, and James Hotvedt.
OTHERS PRESENT: Pat Enright, Peggy Strey, Jason Kakatsch (ECWRP Commission), Greg Loeser (Iola Living Assistance), Don Morgan, Gidget Blank (Greentree Health & Rehab), Chris Enslin (Recover Health), Vicki Johnson (Kindred Hearts), Miriah Westberg (Weyauwega Health Care), Cheryl Buchholtz (Lakeview Manor), Phil Lewin (Fremont Wolf River EMS), Ann Bonikowske and Kay Edelbeck (Community Care Inc.), Dan Mercer (The Chatham Apartments & St. Joseph Residence), Jessica Jenks and Penney Drmolka (Crystal River Nursing Home), DuWayne Federwitz (County Board Supervisor for Town of Mattson), Terry Johnson (Ogdensburg), and Cheryl Breit (CAP Services).
I. ADOPTION OF AGENDA: Motion by Carl Kietzmann, seconded by Dave Lowe to approve amended 7/2/12 agenda. Motion carried
II. APPROVAL OF MINUTES: Motion by Teri Moe, seconded by Dave Lowe to approve April 12, 2012 Minutes. Motion carried.
III. APPROVAL OF SUB-COMMITTEE MINUTES: Motion by Teri Moe, seconded by Jason Kakatsch (as member of subcommittee) to approve May 31, 2012 Minutes. Motion carried.
IV. Discussion on expanding services with partners and other interested parties
A. Brief demographic presentation – A roundtable intro of all in attendance took place. Pat presented an outline of the current discussion calling particular attention to aging demographics from 2005 – 2035 highlighting the ever expanding elderly population within the state due to the aging baby boomers.
B. Status of current services
1. Successes – We have about 30 volunteer drivers transporting riders for medical, nutrition (sites), and employment (mostly the disabled to WCI, etc. and for Community Care Inc. whom we contractually provide services for). We also use our volunteer drivers to provide transportation for Logisticare’s Medicaid eligible customers via contractual agreement.
2. Gaps/Needs per Public Attendees:
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Area/Region |
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Comment |
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Clintonville |
Gidget Blank – Greentree NH & Rehab |
Stated that with Truck City Taxi of Clintonville (they were not able to attend the meeting) provides good service and the cost is good but availability is limited because it is not a large operation |
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Iola |
Greg Loeser – Iola Living Assistance |
Stated they put on about 40K miles/yr serving their resident’s medical needs and knows we have drivers that bring people to the site, but other than that knows little about how people in the general area get around. |
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Manawa |
Terry Johnson - Ogdensburg |
Has some experience with Logisiticare’s service and, although it was rough at first and they are better than they were, but are still working out the bugs. He is not keen on it being a Madison based service and raved about Nancy Ferg and believes Waupaca County does a really good job stating that “it is a shining area for Waupaca County as all drivers are so polite and helpful.” |
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New London |
Kim Ebert – City of New London
Dan Mercer – St. Joseph’s Residence & Chatham Apartments |
The senior van transports from 9 AM – 4 PM, M-F, anywhere within the city limits for anything, including doctor appointments, however, nothing is available outside those hours and it can be difficult to serve everyone because the bus is often full many days in advance. The City of New London charges $3.50/trip on a donation basis. The City pays for this service, which is why it is not available beyond city boundaries.
Feels gap in access to senior van during noon time as nutrition riders take precedence. They do offer transportation to their residents for social needs, etc., but sometimes there is only one person on the bus, which isn’t tractable. |
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Waupaca |
Karl Schulte – Waupaca Taxi |
Provided synopsis on area served and number of rides with goal of 20 minute or less for customer wait time. |
Ø Ann Bonikowske, Community Care Inc. – Kudos to Nancy Ferg for doing such a great job! Believes their partnership with our volunteer driver program works really well.
Ø Jason Kakatsch, ECWRP Commission – Resonated that committee support is huge in plan development.
We have discovered that community networks exist as we are hearing this at our public hearings. Our earlier mini-bus effort was not utilized to the success we had hoped and it became too expensive to continue, even though we believed the overall need continued. Figuring out how best to fill that need is the current goal.
What do most see as a transportation gap that needs to be filled?
To family events, social gatherings they’d like to attend, groceries, and ER visits later in the day
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Question/Statement |
Response |
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Most people do have family and friends to help them with this, but it can be difficult on those resources and some/many don’t even have this option.
We do get dollars from the 85.21 grant to help with this. |
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Many felt the taxi fee was more than fair. |
The taxi is subsidized by state and federal dollars and that the cities would be on the hook if they didn’t make the revenue they do.
Chain subsidizes Waupaca Taxi use on weekends, which works well and is viewed as a good business model |
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Are evening hours doable/profitable? |
Not without more subsidy. |
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Medicare used to pay for ambulance transport to and fro, however, a recent change only provides for transportation to as the return trip is considered non emergent, leaving people and facilities in the lurch to make their own way back, which has become quite problematic. |
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Kindred Hearts - believes the volunteer driver program to be very solid and helpful, but the time frame is limited and it seems too much to ask for Nancy Ferg to serve last minute needs. |
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Crystal River – does use stretcher transportation but finds it costly because it is serviced by Waupaca Area Ambulance |
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Greentree – cited concerns over bariatric transportation needs as difficult because wheelchairs are so wide |
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St Josephs’ Residence – The New London area ambulance operated 3 vehicles to 2 vehicles to now 1 vehicle (as of 7/31), which is a disappointment. Cot transports are considered non emergent, but an ambulance is needed to do them; which they use about 2 times/week. |
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CAP Services - Cheryl Breit: There is a conversation between Ministry Health Care and Portage County occurring regarding transportation issues and there is thought that perhaps medical facilities should have buy-in by perhaps operating their own transportation service or contracting with a specific provider to service this need. |
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Dave Lowe – re the subject of completing survey to determine needs. Most people tend to say yes, they will use it, but end up not doing what they thought they would. It’s all a guessing game – no matter how much you try to anticipate demand. |
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How do we expand within an area like New London that already does it well?
It doesn’t have to be via the use of the county mini bus; maybe a volunteer driver or perhaps a bus from another facility within that area not being used would suffice.
Where do we focus our energies?
For urgent situations, like getting a return trip from a hospital, as opposed to grocery shopping?
Who has a vehicle as part of your business? Are they busy or parked?
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Clintonville: Greentree NH & Rehab |
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Very busy – have PRN driver – see added capability to provide transportation within area |
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Iola: Iola Living Assistance |
2 vans |
Used 75% of the time for transporting tenants/clients of their facilities |
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New London: City of NL
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2 mini-buses
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For residents within city limits only. Any transportation needs – often booked full and days in advance. |
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St Joseph Residence |
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Used for group social activities |
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Waupaca: Crystal River NH & Rehab |
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Use volunteer driver system and local taxi |
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Weyauwega: Lakeview Manor |
Van |
Used mostly for medical. |
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Weyauwega HCC |
No Vehicle |
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Waupaca County does have a mini-bus that groups use occasionally for recreational/social trips.
Karl Schulte/Waupaca Taxi - imagined a coordinated dispatch center which New London could perhaps join, thus saving on their own resources.
Chris Enslin/Recover Health – they basically find their own transportation or call CC Inc. Will do some of their own within a certain radius although private pay insurance liability is often an issue of concern. There are people who would definitely use a transportation service were it to become available.
Is cost a factor? What is a fair price for a local or extended tip (say 10 miles)?
Maybe a voucher ticket program would work best – certainly a better option than cash.
Kim/City of New London - said they had a $3.50 donation but not all users were paying it, and with the rural users not supporting the service, tax-wise, the decision was made to offer it to city residents only – as the taxpaying supporters.
Are people having tough time getting to the Valley, etc.?
It isn’t a problem with medical appointments as our volunteer driver program continues to provide long and short distance trips for those that are elderly (age 60+) or Social Security disabled. Logisticare does this too for the same as long as they are Medicaid eligible recipients.
What happens if your facilities can’t provide transportation?
This happens quite often – many use Koeppen’s if med certified, but it is costly.
Perhaps some in attendance would benefit from participation in the next 5310 vehicle acquisition grant, which is a two year grant cycle, with 2014 being the next available year of interest.
85.21 funds can be used to kick in towards a voucher type program. Shawano County does this.
Pat stated the county’s mini bus can also be a consideration and to contact him. Current usage requires the supply of a driver and the vehicles return with a full tank of gas. A CDL is not required.
Jason mentioned that the New Freedom federal grant is coming out soon and may be something to consider capturing. Owner of grant/recipient would contact w//the provider(s).
Can you compete against current taxi services?
Dave Lowe responded that legally you can have two competing services, but it makes more sense to put it where it doesn’t already exist.
For a voucher program to work you need to have existing services to use and you also need to determine how much and which party is going to pay. Example: county subsidizes taxi fare to take people to nutrition sites.
Most common complaint/need is for social events (but, is it worth $100.00 to go to a birthday party?)
Waupaca’s taxi can go a mile or two outside the city limits as long as one leg of the trip is within the service area.
Is there talk of a taxi service expanding into the New London area?
Dave Lowe – The City of New London may decide (not necessarily a taxi) to do this, but would then have to serve everybody beyond current operation levels. Karl Schulte stated they would need subsidies to operate, but it may be an overall savings to the city
Pat Enright wondered if the old senior van (backup) or the county’s mini-bus could be used to absorb the needs that the ambulance could no longer fill.
Could a set schedule – say every Monday a bus would run to Appleton – it would be something we control or is the need more last minute, unpredictable? The general consensus of the group was that it could be a very viable effort.
Jason said Outagamie County has expressed interest in coordination in the New London area as they are considering the purchase of vehicle with their 85.21 trust fund which would also help out Waupaca County residents (as a split city).
The city of Wausau found that through the coordination of vehicles there were ultimately less vehicles in usage.
There is a sense that shopping is not a great priority so perhaps subsidizing current taxi services and using volunteer drivers might be best for filling that gap at this time.
The State of Wisconsin does offer a Rideshare program for individuals (sorta like a match.com for commuters) per Jason K. Disabled American veterans also offer rides under a separate pot of money.
The group was commended for their input which is vital and they were asked to also help get the word out. The goal is prepare for the ever growing aging friendly communities. Studies have shown a 4 to 1 return economically on every dollar spent on transportation.
V. LOGISTICARE
Things are better now, although there have been many hoops to jump through for reimbursement. Payment timelines have gotten better as billing is now electronic. Jerry asked Jason if he saw things were better with Logisticare who responded “In some areas yes and in others no.” Winnebago County actually got out of their contract for the M.A. transportation which is now a huge issue. They sent a letter to Department of Health Services Secretary, Dennis Smith, asking for a legislative audit of the entire Logisticare program. Only two counties in Wisconsin do what we do – us and Monroe. Other counties wonder how we do it for the cost. If others get more for doing the same, we will be requesting an increase.
The Red Cliff Indian Tribe in Bayfield is holding a forum on this 7/31 to discuss issues with Logisticare.
On 9/1 – Logisticare will be expanding to the 6 county Milwaukee area as they were awarded the contract as the HMO provider. 1/3 of all Medicaid recipients in the state reside within this area.
VI. AMEND WAUPACA COUNTY TRANSPORTATION COORDINATION PLAN
Cap Services is expanding their 0% interest car loan program to Waupaca County through the WETAP grant and are asking for this committee’s formal approval to do so. CAP Services Representative Cheryl Breit explained the Work-n-Wheels Auto Loan Program in detail.
Whereas Waupaca County agrees to amend the 2007 Waupaca County Specialized Transportation Coordination Action Plan to include CAP Work-n-Wheels project - Motion by Carl Kietzmann, and seconded by Jan Henschel Motion carried.
VII. ADJOURN
Motion by Dave Lowe, seconded by Nancy Ferg to adjourn. Motion carried.
NEXT MEETING – October 11, 2012 – 2:00 PM – Waupaca County Courthouse
Respectfully submitted by:
Peggy Strey - Secretary, Aging and Disability Resource Unit